Obsessive Compulsive Disorder.

"It's not your OCD...It's you..."

Why that's your best news


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What's one of the greatest tragedies of living with anxiety?

It's that background voice always whispering in your ear...

At the end of the day, despite whatever you do, the truth is that you have a mental illness. Your brain was designed with defects. Period.

The sad part is that this voice comes even in moments that are trying to convince us that everything is okay.

John, who says he has OCD, went into work on a regular workday and found out from his boss that he got promoted.

Few moments felt as good.

Work had always helped John get away from his OCD. It was a powerful distraction from his obessesions, and a good one. The more he worked, the less time he had to worry about his OCD. At the same time, his company achieved incredible results from John's hard work and serious commitment to his job.

A win-win for both sides.

Today, when John got promoted, was a very important day in his life.

John worked hard for this day. John deserved this day. John's OCD needed to see that good things are indeed possible.

Almost in that very instance, the voice came. "How long before they find out that what you really are is mentally ill? This good news is not meant to last. Forget it."

Fear appeared. Panic appeared. Anger appeared. Sadness appeared.

"Well done John" became "You're really screwed John" in a matter of 5 seconds.

How terribly sad.

The anxiety-free moments just don't last.

"The second I become aware of when a moment is peaceful, there comes that voice. It must be true. My brain really is defective."


How did we get here?

I bet your self-blame wheels have started churning.

"It's me, it's me. I'm mentally ill. I just cannot control my mind. It's true. My OCD will never be cured."

Is that another thought you're buying into? And who exactly put it there? This time it's not you.


 

DOCTOR, WHERE'S MY HOPE?

The medical and mental health industry, and through them, anxiety sufferers, have come to believe that...

...the cause of anxiety is the malfunctioning brain of someone with anxiety.

Thousands of research studies and brain scans spend millions of dollars each year to show exactly which parts of the brain are malfunctioning, misfiring and miscommunicating in anxiety, and how they are doing so.

Every year, millions of dollars of research goes into identifying the precise neural networks in an anxious brain that are compromised, and that work distortedly in anxiety, compared to non-anxiety.

Many medical professionals attribute the misfiring to a chemical imbalance, they say is probably acquired from genetically inherited neurochemistry. They say "who knows for sure, but seems to be it. "

Next, they advocate medication as a hopeful solution to correct these imbalances, as much as possible .

It is no surprise then millions of dollars also go into research studies testing the efficacy of medicines in treating psychological problems.


For those actually suffering in mental pain, this half-baked verdict becomes the end of the story.

Why wouldn't it? They listen carefully for hope and promise of relief, but no one really gives them an unpolluted one.

If my brain itself is disordered, perhaps from birth, perhaps for life, and perhaps a medicine may (or may not) come about to provide relief, but only a partial one, then where’s my hope for a good, uncompromised life?


This is very tragic because it is a conclusion we make on the basis of incomplete information. But one which has serious effects on our ability and motivation to recover.

For many, they lose all hope.


How can I compete with a malfunctioning brain? Don’t I need a functioning brain to be able to do that?
Wow, even a medicine, if it ever works for me, may only ever help me cope. I have no hope for a full recovery.
 

For others, they use it as an excuse to avoid any responsibility for their actions.

Didn’t you hear the doctor? I’m sick. I CAN’T control my anger. I have a brain problem.
 

Whether the message snatches away hope or grants him a lifelong free pass to distressing behavior, in the end, the message sinks down the sufferer even further.

He comes for help, and he leaves like he's hit a new kind of rock bottom.

 
 
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What should we know about our malfunctioning brain?

We should know that malfunctioning brain is only part of the full story. Focusing on only this part is detrimental to recovery.


Dr. Jeffrey Schwartz is a leading research psychiatrist whose pioneering work (1) scientifically proved that the brain, even an anxious and OCD brain, is plastic. That is, it can change despite it's lifelong conditioning of neural misfiring.

Dr Schwartz used self-directed mindfulness to cure anxiety. He was one of the first psychiatric professionals to work on OCD patients who were so drastically debilitated by their condition that they regularly contemplated suicide to end their suffering.


Paula Scott’s OCD was so severe she regularly contemplated suicide. Paula’s illness manifested as the irrational fear that her boyfriend was an alcoholic and drug addict. Paula’s case was particularly compelling because the repetitive behavior she chose to alleviate her fear demonstrated just how aware she really was [of her irrational fear]. She knew, for instance, that if she constantly peppered her boyfriend with questions, he’d realize something was off. “I had to find a way to conceal my feelings from him,” she says, “while still giving in to the compulsion.” Her solution: question him rigorously without tipping him off to her particular fear. She asked him multiple questions about his day, essentially asking him to walk her through what he ate for breakfast, when he got to work, what he did that morning, and with whom he ate lunch, seeing if he might slip and say something that hinted at drug addiction.


Ok, so Paula and his other patients had OCD.

But what exactly was going on in the brain?

Dr. Schwartz and his team undertook research to figure it out.

And they found the "where" of the malfunctioning.

The data were clear. OCD subjects, as opposed to healthy controls, demonstrated significant hyperactivity in the OFC and caudate — even at rest. The images turned up in PET scans as bursts of color, rendering these brain regions as small fires, perpetually burning and, clearly, altering the functioning of the brain even when no episode was underway.


More and more research points out the parts of the brain working abnormally.


Now, here comes the question you must be afraid to ask yourself.

Is my brain not working optimally when I have anxiety?

And here comes the answer.

Yes.

But this is not the cause of your anxiety. It's the effect of anxiety.

It's something I did before the misfiring that caused the misfiring.

If I can change what I do, I can change the misfiring too.


Let's say I have OCD and am repeatedly stuck with a thought that says my mom will die unless I count to 3 every 1 minute.

If someone looks at my brain in a scan when I have this thought, they will see it rapidly misfiring everywhere.

So is the thought what causes my OCD?

No.

It's the decision to follow 3 Mind Distortions that create the OCD.

 

DISTORTION #1:

"IF IT FEELS THIS BAD, IT IS THIS BAD."

The onslaught of a sudden, distressing thought triggers the amygdala .

If we understand how the amygdala works, we'd know what we should do. More particularly, what we should NOT do.

We'd know that it's a false alarm by the subconscious, emotional brain and that the only way to train this part of the brain is by behaviorally demonstrating that there is no threat.

But because we think "If it feels this bad, it is this bad" , we decide to go in a different direction.

"I'll do everything it takes to protect myself from this threat that my thought has predicted. "

And that becomes..

 

DISTORTION #2:

COGNITIVE FUSION.

It's the act of taking a thought literally, as a gospel truth, just because you had it.

It's not your fault.

For all of our life, we've come to believe that when we think about something, we really are dealing with that something. Else why else will I think it?

In other words, we believe that we consciously, purposefully & deliberately produce our own thoughts.

And because all my thoughts contains subject-matter that refers to something, that 'something' by implication has meaning to me, doesn't it?

If I think about my boyfriend cheating on me, it must mean something, because "I" thought it in my own voice, in my own head and it's a thought about a real and tangible person in my life - my boyfriend. It's not someone I made up. Right?

The confusing part for us humans, is that fusion works beautifully in many areas of life, so we aren't so sure what's the dividing line between when it's good for us and when it's not.

Simple a example. What should I eat for lunch today? Let me think. Am I craving pizza or Thai?

What do we typically do to figure this out?

We deliberately fuse, because fusion in
this
context is desirable. It'll help the decision making process.

We go into our heads, imagine ourselves biting into that hot cheesy slice of pizza. Then we imagine tasting a spoonful of that spicy thai curry with hot steaming jasmine rice. Yummmyyy...I think I'm craving Thai more than pizza.

What just happened here?

You cognitively fused with thoughts about food and made the decision. Without that fusion, you'd likely never know what food you are really craving that'll give you the most joy.

Fusion is not a bad thing per se.

Fusion is the reason humans as a species have advanced from jungle days to creating spaceships and landing on the moon. It's our ability to imagine that's enough to problem solve much of life, and make it move along in relatively desirable and planned manner.

Which car should I drive? What degree should I major in? Should I have children? Should I invest in stocks or real estate? Should I eat ice cream or a kale salad?


So the question becomes,

"If I am not supposed to listen (fuse) with my thoughts, how the heck am I supposed to move forward with anything? Where's the diving line between when to listen to the mind and when not to?"

It's when cognitive fusion is taken too far, and in particular applied to contexts in which it would otherwise be healthier not to take thoughts as representative of any whole, absolute truths of life.

"I will always be anxious" as a thought is not representiave of the whole truth is it?

Try to be completely honest here.

Firstly, you don't know the exact future, whether it's tomorrow, next week or the rest of your life.

Secondly, it is not even 100% true that in the past, you were "always" anxious. There HAD to be moments, even if a few hours here and there, when you weren't experiencing anxiety.

But if, just now, in this present moment, you take this thought literally (cognitively fuse), you will likely believe that this thought, and the events this thought is evaulating, are indeed true.

Panic. Panic. Panic.

And this happens just because you overlooked the process of fusion (the way your mind is attaching to the thought) and decided to focus on the products of fusion (the future this thought is trying to evaluate).

When the process undertaken by the mind in thinking about a hypothesized future does not get evaluated as such - that is, as just the process undertaken and nothing more - and instead gets mistaken as the actual future just because fusion took place, then it becomes a problem.

Beacuse then you decide there is no wiggle room between you and your thought.

For you, you become your thoughts.

Your "what if" thought is no longer a "what if". It has become a "it is".

Just because you fused.

That's what makes anxiety, anxiety.

A decision to take every thought literally. A decision to cognitively fuse.

The thoughts about the doomed future are taken literally, despite all objective evidence in the present moment reminding you that the future is not yours to predict with 100% accuracy.

Let's talk about the past.

Perhaps you faced real, valid, legitimate traumas in your past.

If you decide to fuse with the thought that says "100% past = 100% future", without wiggle room, then the hyper-vigilance will leave you blinded to the ways in which the present and future are indeed turning out differently.

In Paula's example, she had a thought about her boyfriend, but instead of dismissing it as random, she decided to fuse with it.

It's this fusion that causes the misfiring.

Paula's preception of a threat amplified, not because her boyfriend did something secretly whacky one day, but because Paula decided to fuse with the thought, and then with each fusion, she trained herself as someone who cannot not ignore her thoughts.

Which essentially amounts to being held hostage by the mind.

At some point, your anxious behaviors become unsustainable, even by you.

It's at this point that we get diagnosed with a mental health crisis.

It's the point in time when so many of Dr Shwartz patients felt so terribly debilitated by their OCD, that they were thinking that suicide is the only way out of this pain.


 

DISTORTION #3:

"MY THOUGHTS ARE THE PROBLEM. I HAVE TO CONTROL THEM."

If we come this far, we've halfway there.

Now, I recognize that the problem is that I take my thoughts, literally.

But many anxiety sufferers get the formula wrong even here.

They insist that in order for them to be anxiety-free, the thoughts have to stop.

We cannot deliberately "stop" or manipulate thinking. It makes matters worse. The thought we are trying to control comes fighting back even more. In fact, it becomes so powerful that it creates new thoughts that we then have to deal with.


Stop thinking this.” > “I will never stop thinking this” > “I will always be scared” > “I will not be able to concentrate on anything else” > “I will have to go to a psych ward” > “I will drop out of college” > “I will never be able to have a job” > “My family will disown me” > “I will never forgive myself” > “I will either want to die or run away so that no one finds me” > “My life is over.


When we try to stop thoughts, then like little spoiled bratty children, the come back fighting more.

This is especially true for thoughts that have been the target of repeated thought suppression (2) .

For anxiety sufferers, those amount to almost all thoughts causing their emotional pains. Their chronic, long-term thought suppression efforts have backfired so badly that these thoughts are now on autopilot.

Remember John in our first case study? Who got promoted at work? And instead of his mind rejoicing with happy thoughts, it produced a mean and viscious OCD thought hijacking John's moment of pride and glory?

Why do you think that happened?

How long do you think John has tried to "control" these thoughts of "having OCD", "being ashamed of OCD" and "never curing OCD"?

You guessed it. A long time. Ofcourse they were bound to show up here as well. They are on autopilot by now.

John never ever tried to do anything else with these thoughts other than trying to control them.

And so tragically the reverse happened. With every effort over the days, weeks, years and decades, it's his thoughts that gained more control. And John felt defeated by them.

Moreover, notice how John decided to cognitively fuse (distortion #2) with the OCD thought and nothing else in his present moment? Did the fact that he had an OCD thought make his promotion and success less true? How come he chose to believe the OCD instead of observing that his life is turning out well?

It's because John's demand is "Only X thoughts; not Y".

Only love, glory, joy and peace.

No fear, anger, sadness and distress. And definitely no "OCD".

Demands on the mind will not and do not work for anybody.

Counterintuitively, permission to the mind to produce any and all crap it wants to, is the way to go. And it's never too late to start.

Why have we been playing this rigged game with our mind?

Most anxiety sufferers have been instructed to do this by their doctors. It's been drilled into them that they think in erroneous ways. And that they have to "stop thinking like this".

What doctors don't understand is that the process of identifying distorted thoughts cannot work to change distorted thoughts.

Thoughts are simply not designed to be controlled by human beings.


For the love of god, where can I break this cycle?

The good news is that you start to break it with a simple tool.

Mindfulness.

You know how I say that the cure to anxiety is behavior , people ask me "what exactly am I supposed to do"?

Announce my courage? Shout at my thoughts? Jump off a plane? Quit my job? What is it?

My answer is Mindfulness.

Mindfulness is your first behavior.

Sometimes, mindfulness is your only necessary behavior.

To the outside eye, it looks like you're a motionless fool. But inside, you're moving mountains.

You're shifting your relationship with your own mind.

And that you can do without moving a leg.

What if I no longer take my anxious thought literally, stop trying to believe it, stop trying to control it, watch it from a distance, watch how my mind starts leaning in, watch how my mind starts leaning out...

...and

...I carry on with my day's plan anyway?

 

Just like that within 60 seconds, you did something different.

You've changed. You're not the same person that you were 60 seconds ago.

What was your behavior before?

Panicking? Popping a pill? Calling your doctor? Googling? Crying to your spouse? Cursing yourself? Withdrawing in shame? Showing up in an emergency ward? Believing your life is forever going to be like this?

Now what did you do?

None of your old reactions.

This time. You sat. You watched. 60 seconds went by and you did nothing.

The old thoughts teased again.

They fought back more.

How dare you!!!!

You watched. You did nothing. Again.

You watched. You did nothing. Again.

You watched. You did nothing. Again.

You just spent 60 seconds as a recovered person.


Your OCD changed from..

THIS..

 
 
 
 

TO THIS..

 
 
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And if you have several OCD or anxious thoughts, what do they become?

THIS...

 
 
 

And your brain?

Your actual, physical, not-to-be joked about brain?

Did any of this mindfulness have a real effect on your brain?

What will the brain scan show?

The misfiring has stopped.


 

This certainly happened with Paula. When she applied mindfulness to her invasive thoughts, she saw victories.

Paula could hold off on questioning her boyfriend about his day for longer periods — first minutes, then an hour or more. She could get by while asking fewer questions. But as time passed, the patients reported something more remarkable: The intrusive thoughts of OCD were diminishing, occurring less frequently, and coming on with less power.
 

Did these new behaviors supported by a mindfulness practice create any change in the actual, physical brain of the sufferers?

Did it indeed prove that the brain can change its own wiring even after years of powerlessness and suffering with mental disorders?

 
His patients, their brains imaged before any treatment began, entered the hulking scanners a second time. Baxter crunched the data and told him the news: The amount of activity in these patients’ OCD circuits had decreased to a degree commensurate with the best results achieved by pharmaceutical therapy. The OCD circuit, so brightly lit in the baseline scans of his OCD sufferers, now glowed more softly.
After Schwartz’s OCD patients mastered mindfulness, their symptoms subsided, and the fire in their brains’ orbitofrontal cortex and caudate nucleus (shown here in green) dimmed.
 

Let's say all the doctors who told you that "anxiety (or OCD) is lifelong" are called Dr Campbell.

This is what you say to them.

"No Dr. Campbell. Turns out, I can have my life back."


But I don't have OCD.

I have day-to-day more realistic, normal, rational worries, stresses, memories, trauma, tragedies and pain.

Ok, so you don't have "OCD" if you are so concerned with diagnostic labels (please don't be; in the end, they're all the same).

But you will agree that your thoughts are a cause of your anxiety, won't you?

After all, all your worries have at some point in human history, been experienced and solved by someone else, right? These issues you're dealing with haven't been specially designed only to be dumped exclusively on you, and no one but you?

If you agree, then can you start to wonder that maybe it's something you're doing, that is within your control, that is causing you specifically to suffer?

And what is that?

Is it the 3 mind distortions we've discusssed here?

Can mindfulness creatively find solutions to all of your psychological pain without trying to push it away? What if you find proof that you can live a meaningful life, guided by your values and goals despite all of your psychological threats - your own thoughts?

If you can do that, they are no longer threats. When you are no longer living in threat, your brain has no need to misfire.

If your brain doesn't misfire, your doctors will no longer have an excuse to slap OCD on you.